The proposed series addresses the prevention and treatment of voice problems in teachers. Data in the literature clearly identify voice disorders as teachers'primary occupational risk not only in the U.S. but also internationally. Moreover, voice problems constitute a global women's health concern. Until recently, few reports have been available around the treatment of these problems in teachers, and even fewer have addressed the equally important question of prevention. The present studies are conducted within the context of a long-range goal to identify effective intervention methodologies for both the prevention and treatment of voice problems in teachers taking into consideration multicultural and linguistic factors. The present studies will report pragmatic data around the effectiveness of two theoretically-driven approaches to the prevention and treatment of voice problems in teachers, (a) voice hygiene education (VH) and (b) voice hygiene education + voice production training in "resonant voice" (VH+VP, essentially the Lessac-Madsen Resonant Voice Therapy program). Participants will be student teachers in Pittsburgh and Hong Kong, who will be followed from student teaching across their second full year of employment as a professional teacher. The central aims are: [1] to evaluate the effectiveness of VH and VH+VP for the prevention of future voice problems in student teachers who are vocally healthy at the outset of the protocol, versus the treatment of voice problems in student teachers who already have them at some level;[2] to evaluate the generality of the findings across teachers in the U.S. and China, using appropriate linguistic and cultural adaptations of the interventions;and [3] to evaluate the feasibility of an internet-based voice exercise and reporting program as a supplement to face-to-face interventions. Ergonomic and personal factors will also be evaluated for their differential ability to predict the risk for future voice problems in teachers. The results should be useful at a practical level, and should also lay the groundwork for future studies assessing similar issues around the prevention of voice problems in teachers, in particular as influenced by multicultural factors within the U.S. The results should also be useful for future studies investigating causal pathways in interventions around these problems. PUBLIC HEALTH RELEVANCE:: The relevance of the project has to do with the need for data around the prevention and treatment of voice problems in teachers. Such problems are teachers'primary occupational hazard, and affect teachers within the U.S. and also globally. Moreover, voice problems in teachers constitute a women's health concern. Although some data have been reported about the effectiveness of various approaches to the treatment of voice disorders in teachers, thus far no prospective randomized data showing robust results have been reported in the literature around the prevention of them. This present series will address this gap by engaging in a collaborative project across the U.S. and China assessing the value of voice hygiene education (VH) versus voice hygiene education + voice production training (VH+VP) for initially healthy student teachers versus student teachers who greater voice concerns. Also, a telehealth technology will be refined and implemented that may have applications in other domains of voice care or speech-language pathology more generally.